NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
Polar Pharmacy, including its subsidiaries, is required by law to maintain the privacy of Protected Health Information ("PHI") and to provide you with notice of our legal duties and privacy practices with respect to PHI. PHI is information that may identify you and relates to your past, present or future physical or mental health or condition and related health care services. This Notice of Privacy Practices ("Notice") describes how we may use and disclose PHI to carry our treatment, payment or health care operations and for other specified purposes that are permitted or required by law. The Notice also describes your rights with respect to your PHI. We are required to provide this notice to your by the Health Insurance Portability and Accountability Act ("HIPAA").
Polar Pharmacy is required to follow the terms of this Notice. We will not use or disclose your PHI without your written authorization, except as described or otherwise permitted by this Notice. We reserve the right to change our practices and this Notice and to make the new Notice effective for all PHI we maintain. Upon request, we will provide any revised Notice to you.
Examples of How We Use and Disclose Protected Health Information About You
The following categories describe different ways that we use and disclose your protected health information. We have provided you with examples in certain categories; however, not every use or disclosure in a category will be listed.
Treatment. We may use your health information to provide and coordinate the treatment, medications and services you receive. For example, we may contact you regarding medications, equipment, supplies, compliance programs such as drug recommendations, therapeutic substitution, refill reminders, other product or service recommendations such as specialty and infusion therapies, counseling and drug utilization review (DUR), product recalls or disease state management.
Payment. We may use your health information for various payment-related functions. Example: We may contact your insurer, pharmacy benefit manager or other health care payor to determine whether it will pay for your medications, equipment and supplies and the amount of your co-pay. We will bill you or a third-party payor for the cost of medications, equipment and supplies dispensed to you. The information on or accompanying the bill may include information that identifies you, as well as the medication you are taking.
Health Care Operations. We may use your health information for certain operational, administrative and quality assurance activities. Example: We may use information in your health record to monitor the performance of the staff and pharmacists providing treatment to you. This information will be used in any effort to continually improve the quality and effectiveness of the healthcare services we provide. We may disclose health information to business associates if they need to receive this information to provide a service to us and will agree to abide by specific HIPAA rules relating to the protection of health information.
We may also use your health information to provide you with information about benefits available to you, and, in limited situations, about health-related products or services that my be of interest to you. If you register youre-mail address on mypolarpharmacy.com, you may elect to receive this information via e-mail.
We are permitted to use or disclose your PHI for the following purposes. However, Polar Pharmacy may never have reason to make some of these disclosures.
To Communicate with Individuals Involved in your care or Payment for your care. We may disclose to a family member, other relative, close personal friend or any other person you identify, PHI directly relevant to that person's involvement in your care or payment related to your care.
Food and Drug Administration (FDA). We may disclose tot he FDA, or persons under the jurisdiction of the FDA, PHI relative to adverse events with respect to drugs, foods, supplements, products and product defects, or post-marketing surveillance information to enable product recalls, repairs, or replacement.
Worker's Compensation. We may disclose your PHI to the extent authorized by and to the extent necessary to comply with laws relating to worker's compensation or other similar programs established by law.
Public Health. As required by law, we may disclose your PHI to public health or legal authorities charged with preventing or controlling disease, injury, or disability.
Law Enforcement. We may disclose your PHI for law enforcement purposes as required by law or in response to a subpoena or court order.
As required by Law. We will disclose your PHI when required to do so by federal, state, or local law.
Health Oversight Activities. We may disclose your PHI to an oversight agency for activities authorized by law. These activities include audits, investigations inspections and credentialing, as necessary for licensure and for government to monitor the health care system, government programs, and compliance with civil rights laws.
Judicial and Administrative Proceedings. If you are involved in a lawsuit or a dispute, we may disclose your PHI in response to a court or administrative order. We may also disclose health information about you in response to a subpoena, discovery request, or other lawful process instituted by someone else involved in the dispute, but only if efforts have been made, either by the requesting party or us, to tell you about the request or to obtain an order protecting the information requested.
Research. We may disclose your PHI to researchers when their research has been approved by an institutional review board or privacy board that has reviewed the research proposal and established protocols to ensure the privacy of your information.
Coroners, Medical Examiners, and Funeral Directors. We may release your PHI to a coroner or medical examiner. This may be necessary, for example, to identify a deceased person or determine the cause of death. We may also disclose PHI to funeral directors consistent with applicable law to enable them to carry out their duties.
Organ or Tissue Procurement Organizations. Consistent with applicable law, we may disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking or transplantation of organs for the purpose of tissue donation.
Notification. We may use or disclose your PHI to notify or assist in notifying a family member, personal representative, or another person responsible for your care, regarding your location and general condition.
Fundraising. We may contact you as part of a fundraising effort.
Correctional Institution. If you are or become an inmate of a correctional institution, we may disclose to the institution or its agents PHI necessary for your health and the health and safety of other individuals.
To Avert a Serious Threat to Health or Safety. We may use and disclose your PHI when necessary to prevent a serious threat to your health and safety or the health and safety of the public or another person.
Military and Veterans. If you are a member of the armed forces, we may release PHI about you as required by military command authorities. We may also release PHI about foreign military personnel to the appropriate foreign military authority.
National Security, Intelligence Activities, and Protective Services for the President and Others. We may release PHI about you to federal officials for intelligence, counterintelligence, protection to the President, and other national security activities authorized by law.
Victims of Abuse or Neglect. We may disclose PHI about you to a government authority if we reasonably believe you are a victim of abuse or neglect. We will only disclose this type of information to the extent required by law, if you agree to the disclosure, or if the disclosure is allowed by law we believe it is necessary to prevent serious harm to you or someone else.
Other Uses and Disclosures of PHI. We will obtain your written authorization before using or disclosing your PHI for purposes other than those provided for above (or as otherwise permitted or required by law). You may revoke an authorization in writing at any time. Upon receipt of the written revocation, we will stop using or disclosing your PHI, except to the extent that we have already taken action in reliance on the authorization.
YOUR HEALTH INFORMATION RIGHTS
Obtain a paper copy of the Notice upon request. You may request a copy of our current Notice at any time. Even if you have agreed to receive the Notice electronically, you are still entitled to a paper copy. You may obtain a paper copy from a pharmacy, home care facility, mail service location or the Privacy Office.
Request a restriction on certain uses and disclosures of PHI. You have the right to request additional restrictions on our use or disclosure of your PHI by sending a written request to the Privacy Office. We are not required to agree to those restrictions. WE cannot agree to restrictions on uses or disclosures that are legally required, or which are necessary to administer our business.
Inspect and obtain a copy of PHI. In most cases, you have the right to access and copy the PHI that we maintain about you. To inspect or copy your PHI, you must send a written request to the Privacy Office. We may charge you a fee for the costs of copying, mailing and supplies that are necessary to fulfill you request. We may deny your request to inspect and copy in certain limited circumstance.
Request an amendment of PHI. If you feel that PHI we maintain about you is incomplete or incorrect, you may request that we amend it. To request an amendment, you must send a written request to the Privacy Office. You must include a reason that supports your request. In certain cases, we may deny your request for amendment.
Receive an accounting of disclosures of PHI. You have the right to receive an accounting of the disclosures we have made of your PHI after April 14, 2003 for most purposes other than treatment, payment, or health care operations. The right to receive an accounting is subject to certain exceptions, restrictions, and limitations. To request an accounting, you must submit a request in writing to the Privacy Office. Your request must specify the time period. The time period may not be longer than six years and may not include dates before April 14, 2003.
Request communications of PHI by alternative means or at alternative locations. For instance, you may request that we contact you at a different residence or post office box. To request confidential communication of your PHI, you must submit a request in writing to the Privacy Office. Your request must tell us how or where you would like to be contacted. We will accommodate all reasonable requests.
Where to obtain forms for submitting written requests. You may obtain forms for submitting written requests from Polar Pharmacy at 2564 East 7th Avenue, North St. Paul, Minnesota, 55109 or call 651-770-6606. You can also visit our website at www.mypolarpharmacy.com to obtain these forms.
NOTICE OF PRIVACY PRACTICES
THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.
STATE LAW SUPPLEMENT
MINNESOTA
Disclosure. For pharmacies that elect to obtain consent pursuant to state law:
We will not disclose your pharmacy records without your consent, except:
- for a medical emergency when the provider is unable to obtain your consent due to your condition
or the nature he medical emergency; or
(b) to other providers within related health care entities when necessary for your current treatment.
Disclosure. We will not disclose your prescription orders or the contents thereof, except to:
(a) you, your agent, or another pharmacist acting on your behalf or your agent's behalf;
(b) the licensed practitioner who issued the prescription;
(c) the licensed practitioner who is currently treating you;
(d) a member, inspector, or investigator of the board or any federal, state, county, or municipal officer
Whose duty it is to enforce the laws of this state or the United States relating to drugs and who is
engaged in a specific investigation involving a designated person or drug.
(e) an agency of government charged with the responsibility of providing medical care for you.
(f) an insurance carrier or attorney on receipt of written authorization signed by your or your legal
representative, authorizing the release of such information; and
(g) any person duly authorized by a court order.
Disclosure: Unless we have obtained your oral or written consent, we will not disclose the nature of pharmaceutical services rendered to you, except as follows:
(a) pursuant to an order or direction of a court;
(b) to other pharmacies;
(c) to you ; or
(d) drug therapy information to your physician.
INTERNET PRIVACY POLICY
Our privacy policy and practices are detailed below. Please read them thoroughly. We make three pledges to you:
1. We will not collect and release personally identifiable information about you without your permission (except as needed to provide to you the services you have expressly requested).
2. You can manage and control the information that you have voluntarily provided to us.
3. You can tell us what your privacy questions and concerns are so that we can respond.
We constantly improve the tools you can use to manage the data that you provide to us. Please refer to this page from time to time to see these new features.
From time to time we receive requests to disclose the identities of our users. We do not disclose the identities of our users unless we are legally required to do so. If a governmental agency, or a law enforcement agency, requests information in relation to the identities of our user, we will comply with the request. If we receive a request by a third party that is not a governmental agency (for example, a request in connection with civil litigation), we will contact the user whose identity has been requested using the contact information the user provided during the registration process. We will wait 10 days after notifying the user before deciding whether to comply with the request by disclosing the identity of the user, unless the request requires us to disclose this information before then. If we cannot wait 10 days because of the deadline in the request, we will let the user know the deadline included in the request when we provide notice that we received it.
We do NOT collect anonymous information from our visitors. We do NOT use cookies. We will not share with third parties any personally identifiable information about you.
An Internet protocol (I.P.) address is a set of numbers that is automatically assigned to your computer whenever you log on to your Internet service provider or through your company's local area network (LAN) or wide area network (WAN). Web servers, the powerful computers that provide web pages for viewing, automatically identify your computer by the IP address assigned to it during your session online. We may collect I.P. addresses for some purposes (for example, to report anonymous user information to our advertisers and to audit the use of our site). We do not link a user's I.P. Address to a person's personal information, which means we will have a record of each user's session but the user remains anonymous to us. PLEASE NOTE: Under certain circumstances, I.P. Addresses and/or domain names may be linked to personally identifiable information, when this information is stored in databases managed by Internet registrars or registries such as Network Solutions or ARIN.
POLAR PHARMACY AND MEDICAL SUPPLIES WILL USE ALL REASONABLE ENDEAVORS TO PROTECT AND KEEP CONFIDENTIAL AND PERSONALLY IDENTIFIABLE INFORMATION IN ITS POSSESSION IN RELATION TO ITS USERS. IF ANY CONFIDENTIAL OR PERSONALLY IDENTIFIABLE INFORMATION IS ACCESSED BY A THIRD PARTY, WHETHER BY NEGLIGENCE OR OTHERWISE OF POLAR PHARMACY AND MEDICAL SUPPLIES, ITS AGENTS, CONTRACTORS, RELATED BODIES CORPORATE, AFFILIATES OR ASSOCIATED PARTIES, TO THE EXTENT PERMITTED BY LAW, MAILRX IS NOT LIABLE TO YOU OR TO ANY PERSON CLAIMING THROUGH YOU IN ANY WAY FOR ANY LOSS, DAMAGE, COSTS, LIABILITY OR OTHER FORM OF CONTRIBUTION.
If you have questions about this privacy policy or the practices of this site, please contact:
Polar Pharmacy and Medical Supplies
Tel: (651) 770-6606
Fax: (651) 770-8017
E-mail: polarpharm@gmail.com
We reserve the right to change this Privacy Policy at any time. All changes will be posted to this page, and we will use commercially reasonable efforts to notify you of any significant changes to this privacy policy.
